Stop Back Pain University

Mobility

Dr. Barry Triestman D.C.

Truckee, Ca. 96161

530-550-1688

Turckeechiropractor.com

Foam roller, yoga mat half foam roller for t-spine exetention, balls, table to roll hamstrings, footballers, strap for ankle mobilzation

This class is not a replacement for a visit to your doctor

Always pay attention to your body. If it is telling you this is enough listen

Ideal alignment

This should be the basis of all of your movements.

This should be the basis of all of your movements.

This should be the basis of all of your movements.

Yes repetition is how we get results and true change

  • So first thing that you always need to do is to find out your alignment and muscular engagement. The more you repeat this whole series of things whether it be in a laying position. Which is what we should always be doing on a regular basis. This gives us tactile sensation from the floor so that what you know where the body is. As you master the this, then move into more complex and complicated positions and movements, like sitting and standing. The starting on the floor and then moving into more challenging positions and activities needs to be hourly initially, and then as we start to “get it”, multiple times throughout the day to set and reprogram or bodies. This reprogramming should be done preferably first thing in morning and before all activities. Activities include sitting and standing. It should be done as breaks especially if sitting to reinforce and reprogram so that we connect and deepen our ability to maintain and control the body. Then as this becomes automatic you add complex movements

Ideal alignment

  • So first thing that you always need to do is to find out your alignment and muscular engagement. The more you repeat this whole series of things whether it be in a laying position. Which is what we should always be doing on a regular basis. This gives us tactile sensation from the floor so that what you know where the body is. As you master the this, then move into more complex and complicated positions and movements, like sitting and standing. The starting on the floor and then moving into more challenging positions and activities needs to be hourly initially, and then as we start to “get it”, multiple times throughout the day to set and reprogram or bodies. This reprogramming should be done preferably first thing in morning and before all activities. Activities include sitting and standing. It should be done as breaks especially if sitting to reinforce and reprogram so that we connect and deepen our ability to maintain and control the body. Then as this becomes automatic you add complex movements

Ideal alignment

  • You're going to bend both your knees to 90 degrees, feet planted hip width apart and knees above feet and under the hips and you want to feel like your feet, knees and legs are in a position where that if you were standing you were ready to you ready to move fast and with power.
  • Now we're going to do the pelvic tilt, tilt the pelvis backwards (posteriorly) and then forwards (anteriorly), move only your lumbar spine and pelvis, don't want your lift your butt off the surface. Do this three times and then find the center of this range of motion. As you get better you will go from I guess this is the center to I think this is the center to I am in ideal position.
  • Shoulders nice and wide and imagine that someone is pushing your arm and shoulder up towards your head and I want you to resist that. This will enable you to feel latissimus dorsi (lats) turn on. You will feel this in the back of your armpit and going down the side of you body. The reason this is important is that latissimus dorsi crosses the lumbar spine and stabilizes the back
  • Back the neck nice and long as if your doing a chin tuck. That's all of that ideal position

Powerhouse

  • Breathing in a specific way
  • Contracting a deep abdominal muscle called the transverse abdominis
  • Contracting the muscles of the pelvic floor

Breath

  • The breath is going to be into the nose out of the mouth through pursed lips and tongue and you're going to make a SHHHH by sound putting your tongue on the roof of your mouth

Abdominal muscles

We have three layers of abdominal muscles

  • The rectus abdominis
  • The abdominal obliques
  • Transverse abdominis which is the one we need at this stage of reprogramming

Put two fingers right here on this pointy hip bone in front of the hip known as the ASIS and then you come just a little bit to the inside. Now I want you to take that breath in and as you're breathing out try to tense where your fingers are.

Muscles of the pelvic floor pelvic floor

It will be helpful to understand where these muscle are in the body and since most don't know I will describe. When we are standing up they are parallel to the floor at about the level of your pubic bone in the front and they go all the way to the front of sacrum in the back. The sit bones which are also known as the ischial tuberosity are borders on the sides. Both men and women have there urethra what we pee though and anus what we poop through go through it. If you are a women vagina also goes through it. When contracting your pelvic floor muscles all the structures that are connected to the pelvic floor,, including the urethra, anus and in the female the vagina towards your head. Can you contract your pelvic floor muscles? Remember that we are just tightening (isometric contraction)the muscles not changing the ideal alignment. One of the common mistakes is to tilt the pelvis when we are tightening/engaging these muscles.

Finding the muscles of the pelvic floor

  • Stop a pee in the middle of peeing but we don't want people to do that on a regular basis because this does promote urinary tract infections.
  • Holding in a fart.

Now you add something that is going to challenge our ability to maintain the alignment and the engagement and what we're going to do is a hip fold. Find ideal alignment, take a breath in, turn on the powerhouse , then a single leg comes up into tabletop, you should only move the hip joint. Then breath in and a again breath out and turn on the powerhouse, the leg goes back down. Alternate legs and get a set of ten on both sides.

Can you contract your pelvic floor muscles?

Remember that we are just tightening (isometric contraction)the muscles not changing the ideal alignment. One of the common mistakes is to tilt the pelvis when we are tightening/engaging these muscles.

Bring it together

Find the ideal alignment, breathe in through your lips and out through pursed lips making the shhh sound. Draw tight the lower abdomen and lift the pelvic floor. What you should feel is a more intense contraction of pelvic floor and transversus abdominis because they have a similar wiring in the body and help each other turn on

Hip folds

Now you add something that is going to challenge our ability to maintain the alignment and the engagement.

  • Find ideal alignment,
  • Take a breath in
  • Turn on the powerhouse
  • Then a single leg comes up into tabletop, you should only move the hip joint.
  • Then breath in and again breath out and turn on the powerhouse, the leg goes back down.
  • Alternate legs and get a set of ten on both sides.

Mobility

Joint movement

Soft tissue movement

8 seconds?

This is the end goal

Movement is life

Joint stuck

Joint stays stuck

Muscle stuck

Muscle stays stuck

The less you move the less you can

The more you move the better

Neck rolls 3 each way gently

Stuck Joint

Leads to:

Improper mechanics effects joints closet most but also far away

Nerve interference nerve to organs, muscles and joints

Altered circulation

Muscle stuck

Abnormal mechanics

Altered blood flow

Acute care

Ice 20 minutes 1 per hour

Drugs side effects?

  • Are useful
  • Slow healing
  • Not more than 7 days

Natural anti inflammatories

Rest

Diet (Glycemic Index)

Bracing good for early care

Supports

Ice

Lay on back with a pillow behind knees on firm surface

Place a large gel pack like the Chattanooga ColPac Cold Therapy, Blue Vinyl, X-Large/Oversized Cold Pack (11" x 21") or Chattanooga ColPac Cold Therapy, Blue Vinyl, Large/Standard-Size Cold Pack (11" x 14")

20 minutes once per hour

Especially before and after activity

Glycemic index

FOOD

Glycemic index (glucose = 100)

Serving size (grams)

Glycemic load per serving

BAKERY PRODUCTS AND BREADS

Banana cake, made with sugar

47

60

14

Banana cake, made without sugar

55

60

12

Sponge cake, plain

46

63

17

Vanilla cake made from packet mix with vanilla frosting (Betty Crocker)

42

111

24

Apple muffin, made with rolled oats and sugar

44

60

13

Apple muffin, made with rolled oats and without sugar

48

60

9

Reinjury

Mechanisms what are they and how can we correct or even better use as new training mode I.e dancing

Warning signs

Hamstrings

  • Flexibility
  • Tenderness when rolling

Don't pick/tear your scab

All tissue heal just like a skin scab

Instability

How is your tolerance to movement

How is easy reinjured

Response to exercise

Response care

Importance of movement

Healing

Remove inflammation

Helps mind

Gross movement walking and micro individual joint

Spasm tension

Spasm due to inflammation responds to anti inflammatories

Tension responds to relaxation techniques i.e breathing

Can be both

Difference

Both to Muscle relaxants

Physcology of back pain

  • Depression everyone gets it. At least a little bit.
  • If you have dealt with depression successfully before, use what has worked then to help now
  • Roller coaster
  • It is normal.
  • Self stupid talk
  • Downward spiral
  • Worse case scenario circular
  • If a small child fell down in front of you was hurt and scared what would do

Time of day

  • To exercise Morning are best
    • Sets the rest of the day
    • Body awareness gets put into other activities
  • Early evenings are also good.
  • Where it it will be part of your life

Plan for

We have different challenges throughout day other responsibilities, energy and motivation levels

Emergencies

Then all of sudden have not done the exercises and reprogramming goes out the door and we need to start from ground zero again

To reprogram

  • First thing in AM, first thing in AM
  • Before activity walk, run, gym, wash dishes, rake, shovel
  • Do powerhouse and alignment then do activity
  • Repeat

If you are competitive

  • As part of your training

Training sessions advanced

Running

Walking fast to slow, arms swinging

Weightlifting*

Biking

Pick an activity go do it. To reprogram

Feeling powerful

You want it

Is sitting the new smoking

  • It delaminates the disk especially those who already have disk injury l-5 S-1 is flexed even in upright posture.
  • Maximum 50 minutes sitting. Set a reminder, timer
  • Pushes the nucleus backwards and cause delamination of annulus,
  • A break is
  • Stand,
  • Hands overhead to extend the lumbar spine,
  • Walk

Wallet out of back pocket,

Siting tips

  • Varied postures while sitting
  • Crossing legs
  • Switch which leg is crossed
  • Legs on desk
  • Feet on a balance disk
  • Ball
  • Different chairs

How to sit

Try aligning the

Pelvis

Try aligning the rib (cage )

Then do both

Externally rotate arms at shoulder

Hands on practice

  • Ideal alignment
  • Powerhouse
  • Stabilize and align first
  • Maintain alignment and stabilization

How deep do you want to go?

Should hurt good

  • The smaller the deeper (small ball or small roller)
  • The harder the deeper
  • How much weight, whether standing and using the wall or laying and putting increased body weight

Additional tips

  • Roll both sides
  • If the side you are rolling on is more tender then the other side, give it some extra attention. The side that gets more attention doesn't have to be the painful side

Joint–Primary Need

Ankle–Mobility (sagittal)

Knee–Stability

Hip–Mobility (multi-planar)

Lumbar Spine–Stability

Thoracic Spine–Mobility

Scapula–Stability

Gleno-humeral–Mobility

Thoracic spine review practice

Roll foam, ½, footballer,

Head support, don’t get the chicken neck

4 breaths just relax and sink into device

  • Arms out to sides
  • Inhale arms up towards ceiling, exhale arms out relax, sink,
  • Inhale arms above the head, exhale arms to ceiling, real, sink
  • Hug
  • Inhale head up exhale, relax, sink, move up or down spine
  • Repeat whole process 4 times 2 reps

Foot rolling

Back and forth

Side to side

Curl and extend toes

Hip mobilize

  • Leg swings
  • Supported
  • unsupported
  • Hip rotations

Glutes

Gluteus maximus

Gluteus medius

Piriformis

Against the Wall

On the floor

Next layer of Glutes

Where we want to work

Posterior calf

  • Foot rolls
  • Knees
  • bent
  • Straight
  • Lower calf can apply more weight than upper

Ilio tibial band

  • A little to the back
  • Top of the hip to just below knee
  • 3 paths
  • Straight side
  • A little to the front

Ankle joint

Either

  • With strap in a lunge position
  • On a bench using your hands

Hamstrings

  • Hips
  • bent
  • straight
  • Knees
  • bent
  • straight

Next session flexibility and stretching

Suggestions? Comments?

Home work

Stop back pain - Google Slides